PFO

I'm 54, female, and have hypertension, shortness of breath, dizziness, and fatigue.  I went blind in one eye for several hours and then again for only a few minutes and was diagnosed as having a TIA and went on Plavix.  An event monitor showed I had many PACs, short runs of SVT's and several short Atrial runs. A recent Echocardiogram indicated a possible hole in my heart. I was referred to a cardiologist who did a TCD Bubble test which said, Bubbles were detected with and without Valsalva, which indicates a possible Patent Foramen Ovale and further TEE or/and clinical correlation is essential.  I was given the results yesterday and my doctor asked that I have an MRI to rule out other causes of the TIA, see an ENT for the dizziness, and will consult with me in a few weeks.  My question is, how can a TCD Bubble test tell if the hole in my heart is a PFO?  What tests determine the type of defect it is? Thanks for any help as I have not been told what the next steps will be.

[kenkeith]

A bubble test views the result of an agent within the blood.  When there is a positive test, bubbles are seen from left to right chamber passing through a wall (septum) that separates the chambers, and that would indicate a hole in the suptum.  PFO would indicate the hole in wall that separates the upper chambers....hole necessary prior to birth, but normally closes subsequent to birth.  A TEE would provide a better viewpoint to evaluate any blood shunting from left to right chambers and sometimes there is double shunting (right to left).